Arthritis occurs when the smooth articular cartilage that lines the joint surfaces becomes damaged and starts wearing out. As the damage accumulates the cartilage roughens and thins, which eventually leads to pain and stiffness.
If your symptoms are affecting your daily activities and sleep, despite adequate non-surgical treatment, it may be time to consider a knee replacement.
Depending on the amount of damage to your knee joint, you may be suitable for a unicompartmental (partial) knee replacement. Though in the majority of cases a total knee replacement (TKR) is more suitable.
The aim of a TKR is to improve your pain and mobility, though you may find that the amount of “bend” is less than your normal knee, but that the replaced knee is much better symptomatically than the arthritic knee.
To perform the surgery an incision is made down the front of the knee, and the arthritic surfaces of the femur (thigh bone) and tibia (shin bone) are cut to fit the metal implants that are cemented on to replace the surfaces. A plastic spacer is inserted to provide a surface for the metal femoral component to slide against, acting as your new knee joint. The wounds are then closed.
After surgery, you will need to recover from the anaesthetic, but as soon as you feel comfortable the physiotherapists will come and assist you with first sitting up and then progress to sitting out of bed to taking your first steps. Usually you will be in hospital for four to five days as your mobility improves to a level that you will be safe at home. You may need to think about whether you will need some help at home for the first week or so.
A follow-up appointment with Mr Lee will be made, to review the wound and remove stitches.
Your mobility will improve over the course of the next few weeks and most patients will need crutches or a stick for the first six weeks. A lot of patients are able to drive at around six weeks, you have to be able to confidently perform an emergency stop to consider driving. Getting back to work may take up to 12 weeks depending on what activities your job entails, this is something Mr Lee will discuss with you. Your knee will continue to improve over the next few months.
If you would like to try your hand at a performing knee replacement, this educational website allows you to perform a virtual knee replacement! Though primarily aimed at children, it is a very informative resource.